Provider Demographics
NPI:1093357220
Name:UJAQUE TRABAL, JOSHUA E (MSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:E
Last Name:UJAQUE TRABAL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB MONTE CLARO 86103
Mailing Address - Street 2:CALLE MONTE LLANO
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656
Mailing Address - Country:US
Mailing Address - Phone:787-941-9982
Mailing Address - Fax:
Practice Address - Street 1:URB MONTE CLARO 86103
Practice Address - Street 2:CALLE MONTE LLANO
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656
Practice Address - Country:US
Practice Address - Phone:787-941-9982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR150921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical